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General NPI Number Information
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NPI Number | 1477632768
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Entity Type | Individual
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Provider Name | KRISTEEN KAYE OUELLETTE P.T.
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3205 S RURAL RD
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City | TEMPE
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State | AZ
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Zip | 85282-3853
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Country | US
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Telephone | 480-730-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 8438 E VIRGINIA AVE
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City | SCOTTSDALE
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State | AZ
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Zip | 85257-1822
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Country | US
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Telephone | 480-945-6052
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2401
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501001650
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License Number State | MI
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